Six years of experience in citoreductive surgery and the application of HIPEC-oxaliplatin.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14676-e14676
Author(s):  
Srdjan Nikolic ◽  
Milan Zegarac ◽  
Igor Djurisic ◽  
Aleksandar Martinovic ◽  
Milan Kocic ◽  
...  
Keyword(s):  
Peritoneal Cancer Index ◽  
Tumor Resection ◽  
Age Distribution ◽  
Disease Free Survival ◽  
R0 Resection ◽  
Years Of Experience ◽  
Peritoneal Carcinosis ◽  
Peritoneal Cancer ◽  
Statistical Relevance

e14676 Background: In this abstract we present six years of experience in citoreductive surgery and intraperitoneal chemotherapy (HIPEC) as treatment for patients with peritoneal carcinosis of colorectal carcinoma. Methods: In six years time 61 patient has been operated. Age distribution was from 27 to 76 and median age was 55. Male/female distribution was 18.13%/81.87%. All patients have been treated with intraperitoneal Oxaliplatin with dose of 410mg/m2 in 2 liters of perfusions. In 93.44% cases R0 resection was done and R1 in 3.28%. There was no patient with R2 resection. In 13.1% cases there was Grade I postoperative complication Adjuvant chemotherapy has been applied to 67.21% of operated patients and most had FOLFOX protocol. By the end of this research we still follow up 55,74 % of patients as 44.26% had lethal outcome. Results: Median (95% CI )overall survival(OS) was 51 month(22+ months) . Disease free survival (DFS) was 23 months (16+ months ) . One, two and six years OS was 78.6% ,58.7% and 50.5% One , two and six years DFS was 68.3%, 46.7% and 38.1%. The research has shown that factors such as patient age, sex, preoperative symptoms, synchronous and metachronous carcinosis had no statistically relevant influence on OS. There was statistic relevance in DFS for patients who developed peritoneal carcinosis within 12 months after primary tumor resection(p=0.03) Carcinosis node size has no statistical relevance on OS(p=0.24) and DFS(p=0.64). Involving of left subdiaphragmal region significantly reduces OS(p=0.0022) , but has no statistically relevant influence on DFS(p=0.49). Involving of left iliacal region was on boundary of statistical relevance on OS(p=0.05). Involving of right subdiaphragmal regions statistically significantly reduces OS(p=0.04) , and has no influence on DFS. Involving of small intestine has statistical relevance on OS(p=0.01) As the most important prognosis factor we highlight the peritoneal cancer index (PCI). Patients with PCI less then 13 have statistically better OS (p<0.01) and also statistically better DFS (p<0.05). Conclusions: Our results show that citoreductive surgery followed up by HIPEC with Oxaliplatin should always be considered for patients with colorectal cancer carcinosis.

scholarly journals Central radiology assessment of the randomized phase III open-label OVHIPEC-1 trial in ovarian cancer

2020 ◽  
Vol 30 (12) ◽  
pp. 1928-1934
Author(s):  
Simone N Koole ◽  
Leigh Bruijs ◽  
Cristina Fabris ◽  
Karolina Sikorska ◽  
Maurits Engbersen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Peritoneal Cancer Index ◽  
Disease Recurrence ◽  
Phase Iii ◽  
Ct Scans ◽  
Recurrence Free Survival ◽  
Open Label ◽  
Free Survival ◽  
Peritoneal Cancer

IntroductionHyperthermic intraperitoneal chemotherapy (HIPEC) improved investigator-assessed recurrence-free survival and overall survival in patients with stage III ovarian cancer in the phase III OVHIPEC-1 trial. We analyzed whether an open-label design affected the results of the trial by central blinded assessment of recurrence-free survival, and tested whether HIPEC specifically targets the peritoneal surface by analyzing the site of disease recurrence.MethodsOVHIPEC-1 was an open-label, multicenter, phase III trial that randomized 245 patients after three cycles of neoadjuvant chemotherapy to interval cytoreduction with or without HIPEC using cisplatin (100 mg/m2). Patients received three additional cycles of chemotherapy after surgery. Computed tomography (CT) scans and serum cancer antigen 125 (CA125) measurements were performed during chemotherapy, and during follow-up. Two expert radiologists reviewed all available CT scans. They were blinded for treatment allocation and clinical outcome. Central revision included Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 measurements and peritoneal cancer index scorings at baseline, during treatment, and during follow-up. Time to centrally-revised recurrence was compared between study arms using Cox proportional hazard models. Subdistribution models compared time to peritoneal recurrence between arms, accounting for competing risks.ResultsCT scans for central revision were available for 231 patients (94%) during neoadjuvant treatment and 212 patients (87%) during follow-up. Centrally-assessed median recurrence-free survival was 9.9 months in the surgery group and 13.2 months in the surgery+HIPEC group (HR for disease recurrence or death 0.72, 95% CI 0.55 to 0.94; p=0.015). The improved recurrence-free survival and overall survival associated with HIPEC were irrespective of response to neoadjuvant chemotherapy and baseline peritoneal cancer index. Cumulative incidence of peritoneal recurrence was lower after surgery+HIPEC, but there was no difference in extraperitoneal recurrences.ConclusionCentrally-assessed recurrence-free survival analysis confirms the benefit of adding HIPEC to interval cytoreductive surgery in patients with stage III ovarian cancer, with fewer peritoneal recurrences. These results rule out radiological bias caused by the open-label nature of the study.

scholarly journals Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis Secondary to Mucinous Adenocarcinoma of the Appendix

2015 ◽  
Vol 100 (1) ◽  
pp. 21-28 ◽  
Author(s):  
David S. Sparks ◽  
Bradley Morris ◽  
Wen Xu ◽  
Jessica Fulton ◽  
Victoria Atkinson ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Cancer Index ◽  
Disease Free Survival ◽  
Effective Treatment Option ◽  
Peritoneal Cancer ◽  
Heated Intraperitoneal Chemotherapy ◽  
Retrospective Clinical Study ◽  
Grade 3

Abstract Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a radical but effective treatment option for select peritoneal malignancies. We sought to determine our early experience with this method for peritoneal carcinomatosis secondary to mucinous adenocarcinomas of appendiceal origin. As such, we performed a retrospective clinical study of 30 consecutive patients undergoing CRS with planned HIPEC at the Princess Alexandra Hospital, between June 2009 to December 2012, with mucinous adenocarcinomas of the appendix. CRS was performed in 30 patients, 13 received HIPEC intraoperatively and 17 received early postoperative intra-peritoneal chemotherapy (EPIC) in addition. Mean age was 52.3 years and median hospital stay was 26 days (range 12–190 days). Peritoneal cancer index scores were 0–10 in 6.7% of patients, 11–20 in 20% of patients and &gt;20 in 73.3% of patients. Complete cytoreduction was achieved overall in 21 patients. In total, 106 complications were observed in 28 patients. Ten were grade 3-A, five were grade 3-B and one grade-5 secondary to a fatal PE on day 97. In patients who received HIPEC, there was no difference in disease-free survival (P = 0.098) or overall survival (P = 0.645) between those who received EPIC versus those who did not. This study demonstrates that satisfactory outcomes with regards to morbidity and survival can be achieved with CRS and HIPEC, at a single-centre institution with growing expertise in the technique. Our results are comparable with outcomes previously described in the international literature.

scholarly journals Reconstruction With 3D-Printed Prostheses After Sacroiliac Joint Tumor Resection: A Retrospective Case-Control Study

2022 ◽  
Vol 11 ◽  
Author(s):  
Feifei Pu ◽  
Jianxiang Liu ◽  
Deyao Shi ◽  
Xin Huang ◽  
Jingtao Zhang ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Operation Time ◽  
Control Group ◽  
Intraoperative Bleeding ◽  
Free Survival ◽  
3D Printed ◽  
Disease Free

BackgroundSacroiliac joint tumor is rare, and the reconstruction after tumor resection is difficult. We aimed to analyze and compare the clinical effects of three-dimensional (3D) printed prostheses and bone cement combined with screws for bone defect reconstruction after sacroiliac joint tumor resection.MethodsTwelve patients with sacroiliac joint tumors who underwent tumor resection and received 3D-printed prostheses to reconstruct bone defects in our hospital from January 2014 to December 2020 were included in the study group Twelve matched patients who underwent sacroiliac joint tumor resection and reconstruction with bone cement and screws in the same time period were selected as the control group.ResultsIn the 3D-printing group, six cases were extensively excised, and six cases were marginally excised. All patients were followed up for 6–90 months, and the median follow-up time was 21 months. Among them, nine patients had disease-free survival, two survived with tumor recurrence, and one died due to tumor metastasis. The MSTS-93 score of the surviving patients was 24.1 ± 2.8. The operation time was 120.30 ± 14.50 min, and the intraoperative bleeding was 625.50 ± 30.00 ml. In the control group, seven cases were extensively excised, and five cases were marginally excised. All patients were followed up for 6–90 months, with a median follow-up time of 20 months. Among them, nine patients had disease-free survival, one survived with tumor recurrence, and two died due to tumor metastasis. The MSTS-93 score of the patients was 18.9 ± 2.6. The operation time was 165.25 ± 15.00 min, and the intraoperative bleeding was 635.45 ± 32.00 ml. There was no significant difference in survival status, intraoperative blood loss, or complications between the two groups (P&gt;0.05). However, there were statistically significant differences in operative time and postoperative MSTS-93 scores between the two groups (P&lt;0.05).ConclusionsAfter resection of the sacroiliac joint tumor, reconstruction using 3D printed prostheses was shorter and resulted in better movement function.

Two-year follow-up of single PD-1 blockade in neoadjuvant resectable NSCLC.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8522-8522
Author(s):  
Shugeng Gao ◽  
Ning Li ◽  
Shunyu Gao ◽  
Qi Xue ◽  
Shuhang Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Disease Free Survival ◽  
Postoperative Treatment ◽  
R0 Resection ◽  
Free Survival ◽  
Treatment Naïve

8522 Background: Early stage non-small-cell lung cancer (NSCLC) could benefit from anti-programmed cell death-1 (PD-1) monotherapy; however, the survival profiles remain to be disclosed. Here, we presented the two-year follow-up outcomes from a phase 1b study of sintilimab, an anti-PD-1 inhibitor in the neoadjuvant setting of NSCLC. Methods: Treatment-naive pts with resectable NSCLC (stage IA–IIIB) received two cycles of sintilimab followed by surgical resection. Postoperative treatment of sintilimab was at the discretion of investigator. The primary endpoint was AE, and key secondary endpoints included major pathological response (MPR), disease free survival (DFS) rate of 1 year and 2 years, and overall survival (OS) rate of 2 years. Results: Among 40 enrolled pts, 36 (90%) underwent R0 resection and were included in the R0 resection population. By data cutoff (January 20, 2021), the median follow-up for DFS and OS for all the enrolled pts was 23.9 (IQR 20.5–24.4) months and 26.4 (IQR 24.2–29.0) months. A total of 12 (33.3%) pts experienced relapse, and 6 pts died. The 1-yr and 2-yr DFS rate was 91.7%/73.3%. The 2-yr OS rate for overall population and R0 population was 87.5%/91.7%, respectively. In the R0 resection population, the median DFS and OS were both not reached. Superior 2-year DFS rates were observed in pts who achieved MPR (MPR vs. Non-MPR: 86.7% vs. 63.8%). DFS of pts with non-squamous cell carcinoma tended to be shorter than that of pts with squamous cell carcinoma (HR 2.71 [95%CI 0.67–11.0], p=0.1479). Pts with tumor mutation burden (TMB) ≥10 mutations/Mb and PD-L1 tumor proportion score (TPS)≥50% tended to have a better 2-yr DFS rate compared to those with TMB<10 and TPS<50. [table] For the post-hoc event free survival (EFS) analysis, the same trend was observed with DFS among different subgroups, and patients with TMB ≥10 mutations/Mb had a significant improved EFS (HR 0.125[95% CI 0.02,1.03], P=0.0222). Conclusions: Anti-PD-1 monotherapy emerged to be a promising neoadjuvant therapeutic strategy for resectable NSCLC with improved clinical outcomes. MPR could serve as a surrogate efficacy biomarker in this setting. Clinical trial information: ChiCTR-OIC-17013726. [Table: see text]

The Impact of Early Recurrence on Quality of Life after Cytoreduction with HIPEC

2017 ◽  
Vol 83 (6) ◽  
pp. 633-639 ◽  
Author(s):  
Nathan M. Hinkle ◽  
Vandana Botta ◽  
John P. Sharpe ◽  
Paxton Dickson ◽  
Jeremiah Deneve ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Cancer Index ◽  
Disease Free Survival ◽  
Early Recurrence ◽  
Oncologic Outcomes ◽  
Low Grade ◽  
Peritoneal Cancer ◽  
Patients At Risk ◽  
The Impact

Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and post-operatively at 2 weeks, and 1, 3, 6, and 12 months. The Functional Assessment of Cancer Therapy-Colorectal instrument was used to determine changes in QoL after CRS/HIPEC and the impact of early recurrence (<12 months) on QoL. Thirty-six patients underwent CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18 and the completeness of cytoreduction-0/1 rate was 97.2 per cent. Postoperative major morbidity was 16.7 per cent with one perioperative death. Disease-free survival was 12.6 months in patients with high-grade tumors versus 31.0 months in those with low-grade tumors (P = 0.03). QoL decreased postoperatively and improved to baseline in six months. Patients with early recurrence had a decrease in global QoL compared with preoperative QoL at 6 (P < 0.03) and 12 months (P < 0.05). This correlation was not found in patients who had not recurred. Patients who undergo CRS/HIPEC have a decrease in QoL that plateaus in 3 to 6 months. Early recurrence adversely impacts QoL at 6 and 12 months. This study emphasizes the importance of patient selection for CRS/HIPEC. The expected QoL trajectory in patients at risk for early recurrence must be carefully weighed against the potential oncological benefit of CRS/HIPEC.

scholarly journals Adjuvant Radiation Therapy for Male Breast Cancer—A Rare Indication?

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3645
Author(s):  
Tobias Forster ◽  
Clara Köhler ◽  
Rami El Shafie ◽  
Fabian Weykamp ◽  
Laila König ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Female Breast Cancer ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Disease Free

Due to its rarity, there are no randomized trials investigating the outcome of adjuvant radiotherapy in MBC. This study reports on patient and tumor characteristics of 41 consecutive MBC patients treated between 1990 and 2018 and on clinical outcomes after surgical resection of tumors and adjuvant radiotherapy of the chest wall or breast. Local control (LC), locoregional control (LRC), overall survival (OS), disease-free survival (DFS), and toxicity were evaluated. After a median follow-up of 80 months (95% CI: 14.6–213.8 months) there was only one recurrence, in a patient’s locoregional lymph nodes 17 months after start of radiotherapy, resulting in an LC rate of 100% at 5 years and a 5-year LRC rate of 97.4% (standard deviation (SD): 0.025). Five-year DFS and OS rates were 64.6% (SD: 0.085) and 57.2% (SD: 0.082), respectively. Adjuvant radiotherapy was tolerated well without high-grade (CTCAE grade > II) adverse events. After tumor resection and adjuvant radiotherapy, LC and LRC rates in MBC patients are excellent and comparable to results found for female breast cancer (FBC) patients. However, as patients are often diagnosed with locally advanced, higher-risk tumors, distant recurrences remain the major failure pattern.

scholarly journals Iliosacral Bone Tumor Resection Using Cannulated Screw-Guided Gigli Saw - A Novel Technique

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tao Ji ◽  
Brian Z. J. Chin ◽  
Xiaodong Tang ◽  
Rongli Yang ◽  
Wei Guo
Keyword(s):  
Local Recurrence ◽  
Tumor Resection ◽  
Surgical Margins ◽  
Osteotomy Site ◽  
R0 Resection ◽  
Primary Tumors ◽  
Current Series ◽  
Common Diagnosis ◽  
Sacral Foramina

Abstract Background Adequate margins are technically difficult to achieve for malignant tumors involving the sacroiliac joint due to limited accessibility and viewing window. In order to address the technical difficulties faced in iliosacral tumor resection, we proposed a technique for precise osteotomy, which involved the use of canulated screws and Gigli saw (CSGS) that facilitated directional control, anteroposterior linkage of resection points and adequate surgical margins. The purpose of the current study was to evaluate whether CSGS technique facilitated sagittal osteotomy at sacral side, and were adequate surgical margins achieved? Also functional and oncological outcomes was determined along with the noteworthy complications. Methods From April 2018 to November 2019, we retrospectively reviewed 15 patients who underwent resections for primary tumors of pelvis or sacrum necessitating iliosacral joint removal using the proposed CSGS technique. Chondrosarcoma was the most common diagnosis. The osteotomy site within sacrum was at ipsilateral ventral sacral foramina in 8 cases, midline of sacrum in 5 cases, and contralateral ventral sacral foramina and sacral ala with 1 case each. The average intraoperative blood loss was 3640 mL (range, 1200 and 6000 mL) with a mean operation duration of 7.4 hours (range, 5 to 12 hours). The mean follow-up was 23.0 months (range, 18 and 39 months) for alive patients. Results Surgical margins were wide in 12 patients (80%), wide-contaminated in 1 patient (6.7%), and marginal in 2 patients (13.3%). R0 resection was achieved in 12 (80%) patients and R1 resection in 3 patients. There were three local recurrences (20%) occurred at a mean time of 11 months postoperatively. No local recurrence was observed at sacral osteotomy. The overall one-year and three-year survival rate was 86.7% and 72.7% respectively.Complications occurred in three patients. Conclusions The current study demonstrated that CSGS technique for tumor resection within the sacrum and pelvis was feasible and can achieve ideal resection accuracies. The use of CSGS was associated with high likelihood of negative margin resections in the current series. Intraoperative use of CSGS appeared to be technically straightforward and allowed achievement of planned surgical margins. It is worthwhile to consider the use of CSGS technique in resection of pelvic tumors with sacral invasion and iliosacral tumors, however further follow-up at mid to long-term is warranted to observe local recurrence rate.

Retroperitoneal dissemination of colorectal ovarian metastases: Basis for rationale use of lymphadenectomy.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 535-535
Author(s):  
C. Eveno ◽  
D. Goárá ◽  
D. Tzanis ◽  
P. Dartigues ◽  
F. Dumont ◽  
...  
Keyword(s):  
Peritoneal Cancer Index ◽  
Specific Pattern ◽  
Peritoneal Carcinoma ◽  
Curative Intent ◽  
Ovarian Metastases ◽  
Systematic Lymphadenectomy ◽  
Peritoneal Cancer ◽  
Paraaortic Lymphadenectomy ◽  
Prospective Database

535 Background: Retroperitoneal lymph nodes are a common site of metastases in primary ovarian cancers and primary peritoneal carcinoma, therefore pelvic and paraaortic lymphadenectomy are recommended. Colorectal ovarian metastases are mostly associated to peritoneal carcionomatosis (PC), which treatment is based on complete cytoreductive surgery (CCRS) associated to intraperitoneal chemotherapy (IPC). The aim of this study was to compare the rate of nodal (pelvic, paraaortic) recurrences, between 2 groups of patients (pts) operated on PC with ovarian metastases (OM) or without OM. Methods: From January 1994 to December 2009, all consecutive women who underwent CCRS plus IPC, were selected from a prospective database. Demographics, tumor characteristics, surgical procedures and chemotherapy, were analyzed and compared. Results: One hundred and five pts were identified; 63 (60%) had ovarian metastasis (synchronous or metachronous). Groups were comparable for all variables, except for the median peritoneal cancer index which was lower in the OM group (9 vs.10.5, p<.05). Nodal recurrences were diagnosed in 19 pts (18%), in paraaortic nodes in 14 pts (74%), pelvic nodes in 7 pts (36%), both in 2 pts (10%) and were associated to other relapse in 15 pts (80%). All these nodal recurrences occurred in the OM group (30% vs. 0, p<.001). After a median follow-up of 74 months (10-196), 3-year overall survival rate was greater in pts without nodal recurrences (71 vs 41 %, p=0.37) and at the end of the study, there was significantly more patients died of disease in case of nodal recurrence (24/44 vs 5/19, p=.04). Conclusions: Nearly one third of patients with ovarian metastases experienced paraaortic and pelvic nodes recurrences. This may due to the specific pattern of lymphatic spread of ovary, well known in primary carcinomas. Therefore, systematic lymphadenectomy should be studied in patients with colorectal ovarian metastases treated in curative intent. No significant financial relationships to disclose.

Role of neoadjuvant therapy (NAT) in pancreatic adenocarcinoma (PAC): A single center experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15747-e15747
Author(s):  
Rami Mohamad Nassabein ◽  
Corentin Richard ◽  
Jean-Pierre M. Ayoub ◽  
Francine Aubin ◽  
Marie-Pierre Campeau ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Standard Of Care ◽  
Tumor Board ◽  
Rank Test ◽  
R0 Resection ◽  
Single Center ◽  
Single Center Experience

e15747 Background: Surgical resection of PAC followed by adjuvant therapy is the standard of care for non-metastatic resectable tumors. Surgical resection with clear margins of borderline (BR) or locally advanced (LA) tumors is either challenging or impossible. Furthermore, there are no clear recommendations concerning NAT for non-upfront resectable PAC. Thus we reviewed our own experience with different NAT modalities for BR and LA PAC. Methods: Medical records of patients identified by Tumor Board as BR or LA PAC and treated with NAT at Centre Hospitalier de l’Université de Montréal (CHUM) were retrospectively reviewed. Survival curves were estimated by the Kaplan-Meier method and compared with the Log-rank test. For both univariate and subgroup analyses, hazard ratio and 95% confidence interval were estimated by Cox proportional hazard regression. Results: Between 2009 and 2017, 90 patients (50 BR, 40 LA) were identified. Chemotherapy, mostly FOLFIRINOX, was the only NAT in 51 patients (56.6%), 23 patients (25.3%) received chemoradiotherapy alone and 16 patients (17.7%) received sequential treatment of both modalities. Tumor resection was achieved in 44 patients, with 32 BR patients (R0: 68.7%) and 12 LA patients (R0: 75%). Median Disease free survival (DFS) of patients that underwent resection was 12.3 months. mPFS was 29 vs 10 months (HR:0.2; p < 0.001) and mOS was 41.7 vs 15.7 months (HR:0.3; p < 0.001) in resected and non-resected patients, respectively. In subgroup analysis, resection statistically improved PFS and OS regardless of age, sex, T stage and type of vessel involvement. Treatment with more than one modality showed better clinical outcomes (PFS and OS) and a non-statistically higher R0 resection rate that was 100% in BR tumors. OS in patients with resected cancers was not reached for the multimodality group, 41.7 months for chemotherapy alone group and 22.4 months in patients treated with chemoradiotherapy group (p = 0.017). Conclusions: In this retrospective single center analysis, NAT with chemotherapy and/or chemoradiotherapy appears to improve patients’ clinical resection results and outcomes. These results validate previous retrospective studies but warrant large prospective trials to define the best NAT.

scholarly journals Intraperitoneal collagenase as a novel therapeutic approach in an experimental model of colorectal peritoneal carcinomatosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
D. García-Olmo ◽  
P. Villarejo Campos ◽  
J. Barambio ◽  
S. Garcia Gomez-Heras ◽  
L. Vega-Clemente ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Peritoneal Cancer Index ◽  
Local Treatment ◽  
Peritoneal Metastases ◽  
Fixed Dose ◽  
Therapeutic Approaches ◽  
Peritoneal Cancer ◽  
Colorectal Origin ◽  
Experimental Rat Model

AbstractThe usefulness of local collagenase in therapeutic approaches to solid tumors has been tested recently. In this study, we evaluate the safety and efficacy of intraperitoneal collagenase associated or not to mitomycin for treatment of colorectal peritoneal metastases in an experimental rat model. Using a fixed-dose procedure, we found that a dose of collagenase of 37 IU/mL administered for 15 min with a hyperthermia pump at 37.5 °C, both in isolation or associated to sequential treatment with intraperitoneal mitomycin, led to a macroscopic decrease in tumor volume as evaluated by the modified peritoneal cancer index (mPCI). Concerning the safety of the procedure, the animals showed no physiological or behavioral disorders during 8 weeks of follow-up. Local treatment for peritoneal metastases of colorectal origin with intraperitoneal collagenase has proved safe and effective in an experimental murine model. Therefore, the stroma-first approach by enzymatic breakdown of collagen from the tumor's extracellular matrix provides a new therapeutic target for colorectal peritoneal metastases.

Sign in / Sign up

Export Citation Format

Share Document